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Medicare Advantage and the Financial Toxicity of Alzheimer's Disease and Related Dementias

Award Number: R01AG091586
ORGANIZATION: NATIONAL INSTITUTE ON AGING
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)
PERIOD OF PERFORMANCE START DATE: 09/01/2026
PERIOD OF PERFORMANCE END DATE: 05/31/2031

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Medicare Advantage and the Financial Toxicity of Alzheimer's Disease and Related Dementias - PROJECT SUMMARY Alzheimer’s Disease and Related Dementias (ADRD) impose unique financial burdens on patients and their families due to patients’ difficulties managing money and extensive health and social care needs over a prolonged duration. An estimated 12 million older Americans will have ADRD by 2050. The lack of treatments to prevent or reverse ADRD combined with brain changes that make patients susceptible to fraud and poor financial decision-making highlights the need to prevent monetary losses. Catastrophic financial losses like bankruptcy and foreclosure not only pose significant economic challenges but are independent risk factors for poor health outcomes. In work focused on Traditional Medicare (TM), we showed that impaired financial behavior begins almost a decade prior to clinical recognition of ADRD. However, Medicare Advantage (MA), the managed care alternative to TM has recently emerged as the dominant source of Medicare coverage. MA includes features that may help enrollees manage ADRD, such as greater flexibility to pay for home-based and social care services. Yet, MA networks can be difficult to navigate with cognitive impairment and there are growing concerns about benefit design choices leaving patients with greater expenses and exacerbating the financial challenges of ADRD. In addition, MA enrollees may have lower levels of financial literacy, which could further impact their financial presentation. Given that MA now enrolls more than 50% of the Medicare population, understanding the ADRD financial presentation in this group is of paramount importance. While many studies consider quality and access in MA, few studies have assessed financial burden, especially with ADRD. To fill this gap, our expert team of team of economists, health services researchers, and geriatricians will leverage and expand a unique data linkage of Medicare claims and consumer credit data that we have developed over the past 8 years to address 3 key questions: 1. Are catastrophic financial events more common with ADRD in MA vs. TM? Is this different for other chronic conditions associated with financial toxicity? 2. Do Medicare beneficiaries with ADRD experience financial difficulties (including more common and less severe outcomes like missed bill payments along with catastrophic events) after changing Medicare coverage type or change coverage type in response to financial difficulties in comparison to those who do not switch? 3. Do MA enrollees with ADRD experience more adverse financial events after hospitalizations that likely require post-acute care compared to those with TM? Findings from this study are critical for determining whether ADRD detection algorithms can be created without additional use of Medicare claims data.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2026 ( Subtotal = $669,195 )
2026	2026	THE REGENTS OF THE UNIVERSITY OF COLORADO	13001 E 17TH PL STE F428	AURORA	CO	80045	ADAMS	USA	Aging Research	000	1	8/11/2026	NEW	$669,195
														Subtotal = $669,195

Grand Total All Awards = $669,195

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Medicare Advantage and the Financial Toxicity of Alzheimer's Disease and Related Dementias

Award Number: R01AG091586

ORGANIZATION: NATIONAL INSTITUTE ON AGING

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

PERIOD OF PERFORMANCE START DATE: 09/01/2026

PERIOD OF PERFORMANCE END DATE: 05/31/2031

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